Predictie van functionele achteruitgang bij ambulante geriatrische patiënten op de spoedgevallendienst

Doel Het doel van deze studie is de predictieve validiteit te onderzoeken van vijf screeningsinstrumenten in het voorspellen van functionele achteruitgang bij ouderen die ambulant verzorgd werden op een spoedgevallendienst. Methode Bij 83 ouderen die ambulant op de spoedgevallendienst van UZ Leuven werden verzorgd, werden de Identification of Seniors at Risk (ISAR), Triage Risk Screening Tool (TRST), de vragenlijst van Runciman, de vragenlijst van Rowland en de Voorlopige Indicator voor Plaatsing (VIP) afgenomen. De functionele status 14 dagen voor opname, bij opname, en 14, 30 en 90 dagen na ontslag werd in kaart gebracht met behulp van de Katz schaal. Resultaten De screeningsinstrumenten met de beste verhouding tussen de sensitiviteit en negatief predictieve waarde 14 dagen na ontslag zijn de vragenlijst van Rowland en de ISAR. Dertig en negentig dagen na ontslag is dit de ISAR. Conclusie Uit dit onderzoek blijkt dat, in aanmerking genomen dat voor een screeningsinstrument de sensitiviteit en negatief predictieve waarde de belangrijkste parameters zijn, de ISAR het meest geschikte instrument is om functionele achteruitgang bij ouderen na een ambulante verzorging op de spoedgevallendienst te voorspellen. De ISAR is eenvoudig in het verpleegdossier te integreren en kan standaard bij elke patiënt op de spoedgevallendienst afgenomen worden

The professional self-image of nurses in Belgian hospitals: A cross-sectional questionnaire survey

This paper reports data on the professional self-image of 9638 nurses employed in 22 Belgian general hospitals with the goal of identifying problems affecting recruitment and retention. Nurses reported having a positive self-image. Most were proud to be a nurse and considered themselves competent health professionals having great responsibility. Although they reported that an ideal practice requires effective teamwork, supportive management, societal recognition, and sufficient time to perform their duties, they also felt that these essential conditions were absent in daily practice. (c) 2005 Elsevier Ltd. All rights reserved

Sequence and origin of the Streptomyces intergenetic-conjugation helper plasmid pUZ8002

Conjugation of plasmids from Escherichia coli is essential for the genetic manipulation of Streptomyces spp. To facilitate intergeneric conjugation from E. coli to Streptomyces the conjugative machinery required for genetic transfer is usually provided by the non-transferable helper plasmid, pUZ8002. Here we present the complete nucleotide sequence of pUZ8002, describe the previously undocumented creation process, and provide details of the sequence relative to the parental pUZ8 plasmid and another previously published pUZ8002 sequence

Biosynthesis of aurodox, a Type III secretion system inhibitor from Streptomyces goldiniensis

The global increase in antimicrobial-resistant infections means that there is a need to develop new antimicrobial molecules and strategies to combat the issue. Aurodox is a linear polyketide natural product that is produced by Streptomyces goldiniensis, yet little is known about aurodox biosynthesis or the nature of the biosynthetic gene cluster (BGC) that encodes its production. To gain a deeper understanding of aurodox biosynthesis by S. goldiniensis, the whole genome of the organism was sequenced, revealing the presence of an 87 kb hybrid polyketide synthase/non-ribosomal peptide synthetase (PKS/NRPS) BGC. The aurodox BGC shares significant homology with the kirromycin BGC from S. collinus Tϋ 365. However, the genetic organization of the BGC differs significantly. The candidate aurodox gene cluster was cloned and expressed in a heterologous host to demonstrate that it was responsible for aurodox biosynthesis and disruption of the primary PKS gene (aurAI) abolished aurodox production. These data supported a model whereby the initial core biosynthetic reactions involved in aurodox biosynthesis followed that of kirromycin. Cloning aurM* from S. goldiniensis and expressing this in the kirromycin producer S. collinus Tϋ 365 enabled methylation of the pyridone group, suggesting this is the last step in biosynthesis. This methylation step is also sufficient to confer the unique type III secretion system inhibitory properties to aurodox. IMPORTANCE Enterohemorrhagic Escherichia coli (EHEC) is a significant global pathogen for which traditional antibiotic treatment is not recommended. Aurodox inhibits the ability of EHEC to establish infection in the host gut through the specific targeting of the type III secretion system while circumventing the induction of toxin production associated with traditional antibiotics. These properties suggest aurodox could be a promising anti-virulence compound for EHEC, which merits further investigation. Here, we characterized the aurodox biosynthetic gene cluster from Streptomyces goldiniensis and established the key enzymatic steps of aurodox biosynthesis that give rise to the unique anti-virulence activity. These data provide the basis for future chemical and genetic approaches to produce aurodox derivatives with increased efficacy and the potential to engineer novel elfamycins